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    Clinton's Health Care Reform Cries Will Go Unanswered


    If you're interested in a solid patients' bill of rights bill, which will help you if you choose to fight your HMO, or if you're interested in coverage for outpatient prescription drugs under Medicare, you'll have to wait until next year, or later. Next year, there are no federal elections. Congress will be more receptive to changes.

    However, even next year enactment won't be easy. There remain very fundamental philosophical differences between the Democrats and the Republicans over how to achieve these objectives. It really comes down to what role the federal government should play and what role the private sector should have.

    One example: The Democrats supporting Medicare coverage of outpatient drugs believe that the federal government should run the reimbursement system, just as it does now. This would put enormous power and leverage in the hands of federal bureaucrats but would enable the government to control prices and assure equity.

    The Republicans supporting outpatient prescription drug coverage want it administered through existing private insurance plans. They argue that about two-thirds of the elderly now have some prescription drug coverage, and the coverage can be extended to all seniors by providing federal dollars. They argue that not everyone needs the same coverage and therefore not everyone should be required to pay for it.

    The only way that legislation can be enacted next year or in subsequent years is if a compromise can be reached between these two very different views of the role of government.

    For this year, the prognosis seems clear: Given this year's elections, there is no way that such differences can be reconciled in 75 legislative days. It is becoming more evident that President Clinton will have to look elsewhere for his legacy.

    Wayne Pines, WebMD's Washington columnist, is a former Associate Commissioner and Chief Spokesman of the Food and Drug Administration. The opinions expressed in this article are not necessarily those of WebMD.

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